Background: High numbers of maternal mortality rate and child mortality rate continue to be the pressing issues in Indonesia. To tackle this problem, multiple approaches have been undertaken, particularly through distributing a Maternal and Child Health (MCH) handbook to every pregnant woman. However, despite the widespread usage of such handbook, its true efficacy in supporting safe motherhood by improving maternal knowledge on various stages of pregnancy and the associated obstetric danger signs is relatively unknown and remains to be established.
Methods: This is a primary cross-sectional study conducted at Majalengka General District Hospital on recently delivering postpartum women between August and September 2017. A total of 127 women were recruited and later divided into two separate groups according to their self-admission on the degree they had read the MCH handbook (C 50% and\50%) and administered a prevalidated questionnaire to assess their knowledge around pregnancy and its danger signs.
Results: We discovered that our population had high knowledge around pregnancy and its danger signs, and the MCH handbook did not hold a significant role in effecting this finding (p value 0.295). Furthermore, various sociodemographic factors (age, educational backgrounds, welfare status, distance from healthcare center, parity and number of ANC visits) also did not exert a statistically significant influence on the level of knowledge in our population (p values 0.579, 0.521, 0.617, 0.908, 0.342, 0.618 and 0.939 respectively).
Conclusion: To conclude, the MCH handbook did not exert a significant influence in improving maternal knowledge levels around pregnancy and the associated obstetric danger signs.
Background: The rate of institutional deliveries in India is 78.5%. Kerala and Tamil Nadu (99.8%) had the highest numbers of institutional deliveries in 2010–13, but still it is less than 60% in about 170 districts in the country. Balrampur (Uttar Pradesh) has recorded the least institutional deliveries in the country.
Objectives: To assess the factors associated with low utilization of healthcare institutions for delivery in rural Balrampur district, Uttar Pradesh.
Methods: A community-based cross-sectional survey was conducted among mothers between the ages of 15–49 who gave birth 12 months before the study in Balrampur district, Uttar Pradesh. Both qualitative and quantitative methods were used for the study. Multistage random sampling was used to select the participants for the quantitative study. Qualitative data collection was done using in-depth interview among 10 women.
Results: Mothers who were not desirous of having more children had a 2.7 times greater chance of delivering at home compared to mothers who were desirous of having more children (OR 2.705, CI 95% 1.189–6.155). Women who married before 18 years of age had a greater chance of home delivery than women who married later (OR 2.381, CI 95% 1.034–5.482). Respondents living far away from home (more than 30 min–1 h travel) were more likely to deliver at home compared to those living close by (OR 2.385, CI 95% 2.357–8.028). Women who were unaware of complications of pregnancy were more like to deliver at home compared to their counterparts who were well aware (OR 2.355, CI 95% 1.677–3.309). Qualitative data showed that cultural beliefs, financial problems, lack of decision making power by the pregnant women were significant determinants of non-utilization of institutional deliveries. Conclusion Despite the cash incentive program, strong cultural and social factors prevent women from accessing institutional deliveries in Balrampur district of UP.
Background: When a mother loses a baby after the period of viability, there is no way to fathom her grief, neither any words, nor an explanation. It is an unexpected event. Stillbirth presents a situation where the early activation of the grief process primarily in mother is exacerbated by the circumstances surrounding the loss. It thus becomes imperative for the healthcare providers to evaluate the significance of parent’s perception on the loss and the factors contributing to it before the initiation of therapy. Objective To evaluate the psychosocial impact of stillbirth among mothers and its contributing factors.
Materials and Methods: A WHO-funded prospective study was conducted in VMMC and Safdarjung Hospital from September 2015 to August 2016 on all women who gave birth to a stillborn baby, using a questionnaire based on EPDS, after taking their written informed consent. Data were entered on the predesigned proforma and analyzed after applying Chi-square test, keeping a null hypothesis value of 15% for all the variables.
Results: Out of the 709 women who delivered stillborn babies, 645 respondents, who willingly consented to participate, were included in the study. There was a significant relationship between psychosocial impact after perinatal loss and support from caregiver and family.
Conclusion: Mothers with stillborn fetuses should be screened for psychosocial impact and offered support when needed. Appropriate counseling by healthcare providers and continued psychosocial and emotional support by family members must be provided.
Purpose: To evaluate the effects of intravenous tranexamic acid (TA) and sublingual misoprostol on reducing bleeding after cesarean section.
Materials: One hundred and fifty-eight participants with term pregnancies scheduled for cesarean section were randomly divided into two groups. In M group, two sublingual misoprostol pills (400 mg) were administrated, immediately after the delivery. In TA group, ten minutes before skin incision, TA ampoule (1 g) was injected. In both groups, immediately after the delivery, 20 units of oxytocin in 1 L ringer lactate with speed of 1000 CC/h was injected. At the end of the operation, the amount of bleeding was measured based on the number of small and large gauzes, the blood in the suction container and the difference of patient’s hemoglobin before and 24 h after surgery.
Results: Hemoglobin level reduction in the TA group was higher than the M group (- 2.45 ± 0.84 vs - 2.14 ± 1.38 g/dL) (P\0.001). Furthermore, number of used gauze and blood suction in the TA group was significantly higher compared to sublingual misoprostol (4.67 ± 1.34 vs 3.25 ± 1.31 and 260.25 ± 79.06 vs 193.94 ± 104.79 cc, respectively) (P\0.001). Mean blood pressure during the entire duration of surgery in the TA group decreased significantly as compared to the M group (P\0.001).
Conclusion: Total bleeding was significantly lower in sublingual misoprostol as compared to the tranexamic acid group. Furthermore, in misoprostol group hemodynamic variables were stabilized greater than tranexamic acid group.
Registration Number IRCT201708308611N6
Objective: The aim of this study was to compare the efficacy and safety of sublingual and vaginal misoprostol in second-trimester termination of pregnancy in 24 and 48 h. Study Design This is a retrospective study of 240 pregnant women seeking termination in second trimester (13–18.5 weeks), in which the patients are subdivided into two groups—first group received 400 mcg of misoprostol sublingually (n = 120), and second group received 400 mcg of misoprostol vaginally (n = 120) every 4 h for a maximum of five doses. The course of misoprostol was repeated if the patient did not abort within 24 h.
Results: The mean induction-to-abortion interval was shorter in sublingual group (10.28 ± 3.1 h) versus 14.68 ± 4.2 h in vaginal group in 24 h (p = 0.0001), and 36.9 ± 4.4 h in sublingual versus 29.7 ± 14 in vaginal group in 48 h (p = 0.0933). Mean dose requirement for misoprostol by sublingual route was low as compared to vaginal misoprostol (1048 ± 301 mg versus 1250 ± 375 mg; p = 0.0001 in 24 h and 1110 ± 833 mg versus 1325 ± 536 mg; p = 0.0231 in 48 h). No significant difference was found in the success rate (both at 24 and 48 h) and in side effects among the two comparison groups.
Conclusion: Misoprostol as such by any route has been proven as an effective abortifacient in second trimester. Both sublingual and vaginal routes are effective for medical abortion. But shorter induction-to-abortion interval in sublingual route, less dose requirement and higher acceptability makes sublingual route as a better choice.
Introduction: There is a definite need to find a highly sensitive and specific, noninvasive, and cost-effective marker for prediction of preterm labor. We hypothesize that a measurement of adrenal gland volume can predict a preterm as well as a term labor.
Materials and Methods: Two hundred and sixty-eight pregnant women were enrolled in the study at 28–34 weeks’ antenatal visit. Final analysis was done in 204. All of them were subjected to 2D ultrasonographic measurement of the corrected fetal adrenal gland volume (cFAGV) and fetal adrenal zone parameters including the width ratio and depth ratio. The cohort was followed up to term, and a reassessment of cFAGV and fetal adrenal zone parameters was repeated between 37 and 39 weeks. Women who presented with features of preterm labor had a scan at the time of presentation to record cFAGV and fetal adrenal zone parameters.
Results: Women, who developed features of preterm labor eventually, had a significantly high cFAGV (404.70 mm3/ kg body weight) during the first scan compared to those who reached term asymptomatically (241.35 mm3/kg body weight). A cutoff value of 271.16 mm3/kg body weight showed 90% sensitivity and 81.9% specificity. Fetal adrenal gland width ratio had the best efficacy (sensitivity 96.67%, specificity 86.2%) followed by cFAGV (sensitivity 96.67%, specificity 83%) for predicting preterm delivery.
Conclusion: 2D ultrasound measurement of fetal adrenal gland parameters can be used as a marker for prediction of preterm delivery. cFAGV at term can also be used to predict the possibility of spontaneous onset of labor.
Background: The efficacy of a single bolus dose of epidural dexamethasone added to levobupivacaine–fentanyl combination for labor analgesia has not been studied. In this randomized double-blind controlled trial, we assessed the effect of epidural dexamethasone in reducing the hourly average consumption of epidural levobupivacaine–fentanyl combination in laboring parturients and to study its effect on pain score, maternal satisfaction, maternal and neonatal outcome.
Methods: Sixty adult ASA I-II single-gestation full-term primigravid laboring parturients with cervical dilation B 5 cm were randomly assigned to two equal-sized groups. Combined spinal–epidural block was performed in all the parturients. After placing the epidural catheter in epidural space, 8 mg of preservative-free dexamethasone was administered to the dexamethasone group, and 0.9% saline to the placebo group. All parturients received continuous background infusion of 5 ml of 0.1% levobupivacaine with 2 lg/ml of fentanyl with the provision of patient-controlled bolus of 5 ml of 0.1% levobupivacaine with 2 lg/ml of fentanyl (lockout interval 15 min). The primary outcome measure was the hourly total consumption of levobupivacaine–fentanyl mixture. The secondary outcome measures were maternal satisfaction, pain score, maternal hemodynamic parameters, fetal heart rate, duration of second stage of labor, mode of delivery, Apgar scores and adverse effects.
Results: Hourly drug consumption and hourly bolus requirement were significantly lower in the dexamethasone group than placebo group (6.97 ml ± 1.22 vs. 8.40 ml ± 2.59 and 0.41 ± 0.26 vs. 0.72 ± 0.55, respectively, P = 0.008 for both). There were no significant differences in other outcome measures.
Conclusion: Epidural dexamethasone significantly decreased average hourly drug consumption and the number of boluses in laboring parturients, thus providing epidural drug dose-sparing effect.
Aim: Utero vaginal prolapse is a very common complaint of patients in the OPD. It’s an entity that existed since a very long time and hence many classifications were proposed; however, only one system was found to be a validated system for determining the degree of prolapse— POP-Q system. Objective To determine the relationship of decubitus ulcer with POP-Q staging.
Materials and Methods: A prospective study of 100 patients with complaints of prolapse (something coming out of vagina) was considered. The patients were staged in accordance with POP-Q system. The number of patients with decubitus ulcer were noted. The area of each decubitus ulcer was also noted, by measuring the radius. Statistical tests were applied to find out if the relationship of the presence of and the area of decubitus ulcer with stage of prolapse was significant.
Results: It was found that as the stage of prolapse increased, the number of patients with decubitus ulcer also increased. Also, as the Point C measurement increased, the area (small/medium/large size) of the decubitus ulcer also increased.
Conclusion: There is a definite correlation between the presence of decubitus ulcer along with its area and the POP-Q component. The study also indicated that POP-Q staging is the only method of classification available that allows accurate and standardized measurements, foregoing pitfalls of all previous classifications.
Purpose of the Study Intrauterine contraceptive devices (IUCDs) are highly effective form of long-acting reversible contraception having least number of complications. We aimed to find the incidence, risk factors and the management done for incarcerated and transmigrated intrauterine contraceptive devices at a Tertiary Care Teaching Hospital during past 5 years.
Methods: A cross-sectional retrospective analysis of 5 years (January 2013–December 2017) was done, and the case records from Medical Record Department and Family Planning Unit of our institution were analysed.
Results: Total number of IUCD insertions done in last 5 years (from January 2013 to December 2017) in our institution was 4557. Misplaced IUCDs requiring surgical interventions were 71 (1.6%) out of which 63 (88.7%) were incomplete perforations or embedded and 8 (11.3%) were complete perforations or transmigrated IUCDs. Transmigration sites were omentum, uterovesical fold, mesentery and bladder. Laparotomy was needed in 4 (5.6%), and 2 (2.8%) needed each laparoscopy and cystoscopy. Main risk factors identified were postpartum previous on or two caesarean sections, low parity, grade of operator and IUCD and uterocervical length discrepancy.
Conclusion: The risk of perforation should not be a reason to defer IUCD insertion and every effort should be made to bring down its failure and complication rates.
Objective: To compare the rates of intraoperative and postoperative complications of open and robotic-assisted surgery in the treatment of endometrial cancer.
Methods: This retrospective study was performed at a single academic institution from January 2014 to February 2017 in the Department of Gynecology Oncology at Amrita Institute of Medical Science, Kerala, India. The study included patients with clinically early stage uterine malignancy undergoing open or robotic-assisted surgery.
Data collected included clinicopathological factors, intraoperative data, length of hospital stay and intraoperative and postoperative (early and late and severity according to Clavien–Dindo classification). Morbidity was compared between two groups.
Results: The study included 128 patients, of whom 61 underwent open surgery and 67 underwent robotic-assisted surgery. Mean operative time (P = 0.112), mean estimated blood loss (P\0.001), number of patients requiring blood transfusion (P\0.001) and mean length of hospital stay (P\0.001) were significantly lower in robotic group. None of the patients in robotic group experienced intraoperative hemorrhage (P = 0.010). The early postoperative complications, SSI (P\0.001), infection (P = 0.002), and urinary complications (P = 0.030) and late postoperative complications lymphoedema (P = 0.002), vault-related complications (1.5% robotic vs. 6.6% open) and incisional hernia (none in robotic vs. 4.9% in open) were significantly lower in robotic group. Grade-II complications (Clavien– Dindo classification) were significantly lower in robotic group (P\0.001).
Conclusion: Robotic-assisted surgical staging for uterine cancer is feasible and safe in terms of short-term outcomes and results in fewer complications and shorter hospital stay.
Background: One-third of each woman’s life is naturally during her menopause. This study was conducted to determine the factors related to the quality of life in postmenopausal women.
Materials and Methods: This cross-sectional study was carried out using cluster sampling method on 218 postmenopausal women aged 40–60 years old in Kermanshah 2014. The data were collected through interview and with the standard questionnaire of Menopausal Quality (MENQOL) of Life and analyzed using SPSS software version 19.
Results: The mean age of menopause was 50.03±4.48 years. Mean scores of quality of life and four domains, vasomotor, psychosocial, physical and sexual were 3.15±0.970, 3.71 ± 1.81, 3.32±0.959, 2.91 ± 1.06, 3.74 ±1.59, respectively.
Conclusion: Chronic conditions such as hypertension in postmenopausal women can lead to lower quality of life. Therefore, provision of coherent support programs for controlling chronic diseases requires serious intervention from health care providers.
Objective: We aimed to investigate the association of pregnancy associated plasma protein A (PAPP-A) levels in late first trimester with small for gestational age (SGA) neonates and adverse pregnancy outcomes in a low-income setting.
Methods: The inclusion criteria were late first trimester (11–13 ? 6 weeks) women with singleton and nonanomalous pregnancy. Enrolled participants were sampled for PAPP-A and prospectively followed up for delivery outcome and antenatal complications. A multiple of median (MoM) was calculated and statistically compared between groups.
Results: Out of total 284 subjects, 14.54% delivered SGA babies and formed cases (Group A), 66.5% delivered appropriate for gestational age (AGA) neonates with uneventful antenatal period (controls, Group B), and 19.3% were AGA group with adverse pregnancy complications (Group C). The late first trimester median PAPP-A MoM was significantly lower (0.61) in Group A compared to Group B (1.47). Using receiver operating characteristic (ROC) curve for PAPP-A MoM, optimal cutoff value was found at 0.45 MoM, with positive predictive value of 56.2%, specificity of 92.6% and sensitivity of 45%. The median interquartile range (IQR) of PAPP-A MoM value in Group C in comparison with Group B was significantly lower except for abruption. At PAPP-A MoM cutoff value < 1, < 0.8, < 0.6 and < 0.4, the odds ratio for adverse pregnancy outcome was 8.30, 7.29, 10.97 and 10.60, respectively, indicating an inverse relationship.
Conclusion: With 0.45 MoM cutoff of PAPP-A, the detection rate, specificity and positive predictive value for SGA were 45, 92.6 and 56.2%, respectively. As PAPP-A MoM values decreased, the odds ratio of having adverse pregnancy outcomes increased.
Pregnancy-associated plasma protein A, Small-for-gestational age, Fetal growth retardationBackground: The incidence of post-partum anaemia (PPA) is 14–24%. Treatment of PPA with injectable iron replenishes the iron store. Ferric carboxymaltose complex (FCM) is a non-dextran containing intravenous iron agent, having a very low immunogenic potential, designed to be administered in large doses in a short period of time.
Objective: To compare the efficacy and safety of intravenous FCM and iron sucrose (IS) in post-partum irondeficiency anaemia.
Material and Method: In this prospective, comparative study, 120 post-partum women with iron-deficiency anaemia (Hb < 10 g%) were divided into two groups. A fixed dose of 1000 mg of FCM or IS was given within 10 days of delivery. Hb and serum ferritin were repeated 14 days posttransfusion.
Result: There is a mean increase in Hb (P value 0.000, 0.000) and ferritin (P value 0.000, 0.000) in both the groups. For intergroup comparison, independent Student’s t test was performed which showed FCM was superior to IS (P value 0.000 and 0.000).
Conclusion: In our study, FCM was very effective in improving Hb concentration as well as in early replenishment of iron stores in patients with PPA. Large doses given in a short period of time not only save hospital resources but also improve patient satisfaction. It has significant benefit for use in the outpatient department. From this study, we can recommend its use in post-partum women with iron-deficiency anaemia.
Ferric carboxymaltose, Iron sucrose, Post-partum anaemia, EfficacyObjective: To assess whether a spot urinary albumin:creatinine ratio (ACR) measured before 20 weeks of gestation can predict subsequent development of preeclampsia.
Methods: The ACR was determined from midstream urine sample taken between 17 and 20 weeks of gestation. Urine albumin was measured by immunoturbidimetric method using commercially available kit (Beckman Coulter) through Beckman AU 480 fully automated biochemistry analyzer. Urine creatinine was measured by modified kinetic Jaffe reaction without deproteinization.
Urine Albuminomg/dlÞ
Urine Creatinineog/dlÞ= UACR in mg/g
Participants were then followed until delivery. Primary outcome measure was preeclampsia, secondary outcome measures were gestational hypertension, gestational diabetes mellitus, IUGR, and normal range estimate of urinary albumin-to-creatinine ratio was established.
Result: The median spot urinary albumin-to-creatinine ratio measured between 17 and 20 weeks of gestation was 5.2 mg/g of creatinine (2.5–9.6). Women who subsequently developed preeclampsia had higher spot urinary albumin-to-creatinine ratio (median 30.795 [9.7–92.8]) in comparison with women who developed gestational hypertension (median 5.2 [0.7–7.2]) and unaffected women (median 5.2 [2.5–9.6]). The urinary albumin-to-creatinine ratio of the mother who developed IUGR was significantly higher. By ROC analysis, the optimum ACR to predict preeclampsia was 9.85 mg/g of creatinine. The relative risk of developing preeclampsia in women with urinary albumin- to-creatinine ratio more than 9.85 mg/g of creatinine was higher than in the women who had urinary albumin-tocreatinine ratio less than 9.85 mg/g of creatinine.
Conclusion: A spot urinary albumin-to-creatinine ratio of more than 9.8 mg/g of creatinine can predict the development of preeclampsia in later pregnancy with the sensitivity and specificity of 67 and 76%, respectively. However, additional studies and cost–benefit analysis are required to confirm these finding before recommending this test for screening purposes.
Preeclampsia, Proteinuria, Microalbuminuria, PregnancyAim: This study determines the prevalence, causes and outcome of pregnancy in women with chronic liver diseases in a tertiary level teaching institute in Southern India.
Methods: Retrospective analysis of case records was carried out between December 2010 and May 2015 in the departments of Obstetrics and Gynecology and Gastroenterology including pregnant women diagnosed to have chronic liver diseases prenatally or during pregnancy.
Results: The frequency of chronic liver disease in pregnancy was 50 among 10,823 deliveries (0.4%). Twenty-six women with chronic liver disease had 50 pregnancies during the study period. Fifty percent of the women had cirrhosis. Maternal complications occurred in 22% of the study group. Variceal hemorrhage occurred in 4%, and hepatic decompensation occurred in 16%. There were two maternal deaths (4%). Obstetric complication such as preeclampsia, postpartum hemorrhage and puerperal infection occurred in 18, 14 and 18%, respectively. Abortion occurred in 34%, 55% in cirrhotic and 4.8% in noncirrhotic. Live birth rate of 76% was significantly higher (p < 0.014) in the non-cirrhotic group compared to cirrhotic group.
Conclusion: Pregnancies in chronic liver disease are associated with high rate of abortions. Live birth rates are better and complications such as variceal bleeding or decompensation of liver disease are less common than previously reported.
Chronic liver disease, Cirrhosis, Pregnancy, Hepatic decompensation, Variceal hemorrhageBackground: Gestational weight gain (GWG) proportional to body mass index before pregnancy is one of the factors on maternal and neonatal outcomes. The aim of the current study was to assess association between GWG, and cesarean section, birth weight and gestational age at birth in women with normal BMI prior to pregnancy.
Methods: This was a cross-sectional study carried out in 103 hospitals in Tehran, the capital of Iran, from July 6 to 21, 2015. The data were extracted by 103 trained midwives. Finally, 2394 pregnant women with normal BMI before pregnancy and singleton birth were examined. GWG was categorized based on Institute of Medicine (IOM) recommendations.
Results: Prevalence of low birth weight (LBW) was 5.41% and prevalence of macrosomia was 2.18%. The prevalence of LBW in women with GWG less than the weight gain recommended by IOM was 2.13 times [95% confidence interval (CI) 1.13–4.02, P = 0.019] more than in women with GWG equal to the weight gain recommended by IOM. There was no statistically significant difference in the prevalence of LBW between women with GWG more than recommended weight gain by IOM and women with GWG equal to the weight gain recommended by IOM (OR = 1.21, 95% CI 0.61–2.38, P = 0.580).
Conclusion: After controlling for confounding variables, the prevalence of cesarean section and preterm birth had no significant difference at various levels of GWG. Accordingly, the prevalence of LBW among women with GWG less than the recommended weight gain by IOM was significantly 2.13 more than that among women with GWG equal to the recommended weight gain by IOM.
Gestational Weight Gain, Preterm Birth, Low Birth Weight, Cesarean DeliveryObjective: Studying the effect of GnRH antagonist administration on the day of hCG to cases of IVF/ICSI with estradiol level above 5000 ng/dl for protection of ovarian hyperstimulation syndrome.
Design: Prospective study.
Materials and Methods: Sixty patients undergoing controlled hyperstimulation COH, for IVF/ICSI using long agonist and E2 level on the day of hCG, are above 5000 ng/dl, 52 patients received single dose of cetrorelix 0.25 mg on the day ofhCG, and 8 patients received two doses of 0.25 mg/day cetrorelix started one day before the day of hCG.
Results: There was no significant difference regarding patients BMI, number of stimulation days, recombinant FSH dose, and number of retrieved oocytes. Clinical pregnancy rate was 76.6% (46/60), in patients received single dose of antagonist PR were significantly higher 80.7% (42/52) versus 50% (4/8) in patients received two doses p = 0.047. Live birth rate was 50% (30/60), abortion rate was 20% (12/60), and preterm delivery was 20% (12/ 60). Mean E2 was 6853.2 ng/dl. Six patients developed moderate ovarian hyperstimulation OHSS (6/60) 10% and no cases of severe OHSS.
Conclusions: GnRH antagonist administration on the day of hCG in cases undergoing IVF/ICSI with long agonist protocol is effective in protection of OHSS and does not affect the clinical pregnancy rate nor live birth rate.
Infertility, ICSI, OHSS, AntagonistAim: The aim of this study was to analyze the utility of routine use of diagnostic office vaginohysteroscopy in the evaluation of uterine cavity in infertility patients prior to IVF-ET.
Materials and Methods: We conducted a retrospective analysis of 1000 women who had undergone routine diagnostic office vaginohysteroscopy as an institutional protocol in the evaluation of infertility prior to IVF-ET cycle at a tertiary care hospital. They were divided into two groups: primary infertility (group I) and secondary infertility (group II). The primary outcome was the finding of an abnormal uterine cavity (congenital abnormality vs acquired abnormality).
Results: One thousand women underwent routine diagnostic office vaginohysteroscopy in the evaluation of infertility prior to IVF-ET. There were no intraoperative or postoperative complications. Vaginohysteroscopy revealed an abnormal uterine cavity in 13.8% (1000 patients) of women. Primary infertility group (I) had 13.19% (811 patients), and secondary infertility group (II) had 16.4% (189 patients) abnormal uterine cavities.
Conclusion: Diagnostic office vaginohysteroscopy has a definite role in the uterine cavity evaluation in infertility patients prior to IVF, but routine use should not be recommended considering the low incidence of abnormal uterine cavity findings. Moreover, the majority of these uterine cavity abnormalities can be detected by less invasive tests such as HSG, TVS, SSG and 3D ultrasound.
Diagnostic office vaginohysteroscopy, Primary and secondary infertility, IVF-ET, Abnormal uterine cavityIntroduction: Healthcare providers are an important link with the general public to impart knowledge regarding contraception. They are an important source of providing information regarding different methods of contraception, their proper use and removing the myths from the couple’s mind. However, their own attitude and practice of contraception are often lacking.
Objective: This study was conducted to assess the attitude and practice of contraception over the last 1 year of nurses in a tertiary care hospital in Jaipur.
Methods: The study was conducted on 410 nurses in a tertiary care hospital. All were given a questionnaire that was duly filled by them, and the data obtained was analysed.
Results: All were aware of at least one family planning method. Only 84% knew that contraceptives could space the pregnancy. Very few had correct knowledge about the fertile period or lactational amenorrhoea. Few were aware of emergency contraception and its proper implication (6.83%) The commonest was the barrier method (70%) followed by natural method (41.46%). There was shifting from natural method to barrier method and OC pills for few cycles.
Conclusion: Health workers have knowledge regarding contraception yet fail to use it regularly. Proper attitude and practice are essential to prevent unintended pregnancies and prevention of STDs. Their use will enhance counselling skills for general population.
Attitude, Contraception, Health workers, Knowledge, PracticeIntroduction: The ‘Standard Days Method’ is a fertility awareness-based method of family planning that identifies day 8 through day 19 of the menstrual cycle as fertile days during which a woman is likely to conceive with unprotected intercourse.
Objective: The study was aimed to determine the effectiveness of a promotional program on the ‘Standard Days Method’ in terms of improving the knowledge scores and attitude scores.
Design: A pre-experimental one-group pretest–posttest research design was adopted. The samples included 365 female postgraduate students from selected colleges of Udupi Taluk, Karnataka. The data was collected using selfadministered questionnaires. The plan for the promotional program was also established.
Results: The findings of the study were analyzed using the descriptive and inferential statistics. The mean pretest and posttest knowledge scores were computed, and it was found that there was an increase in the mean knowledge score from 8.96 ± 3.84 to 32.64 ± 5.59, respectively. It was observed that the promotional program on ‘Standard Days Method’ was effective in improving the knowledge (p< 0.001) and attitude (p < 0.001) of the postgraduate students.
Conclusion: The promotional program on Standard Days Method of family planning was effective in improving the knowledge and attitude of the postgraduate female students. This will enable the women to adopt this method and plan their pregnancies naturally and reduce the side effects of using oral contraceptives.
Attitude, Knowledge, Standard Days Method, Family planning, Promotional program